一论胃气在人之脉固滑而和。本是或有邪淫之来。此脉浑然在中。邪淫日久。此气残伤
。残伤至尽。生气殄矣。所以人须病。而脉犹有胃气者可医。无则不能治也。故胗之时。既是邪
脉。犹当表里之中。寻取胃气也。此脉但可被邪脉伤。终不与邪脉混。故当审察分看。不可
茫茫然无杂别也。人能知此医理。斯过半矣。
一论大肠脉。自外而下降。三焦脉自内而上升。小肠脉。自内而下降。膀胱脉。自外而
上升。故内经云。天阴自上而降。地阳自下而升。是此意也。
详论
一论前载六淫之气来应指下。必有太过不及之形也。倘六脉不实不坚。且散且聚。而症
却在中。此无形而有病也。殊不知人身有六气。有五运。既无六气有余之邪。则必属五运不足之
邪
使毕已之谓欤。邪已遏。正未复。此意也。兼前论看。
一论寒热交争者何也。盖阴外乘阳。阳与阴争（此言寸也）或阳乘阴。阴与阳争。（此言
尺也）
。司治者在表阴邪当升发。以复其阳之性。在里阳邪当降敛。以复其阴之性。阴阳得位。于
寒热何争之有。若夫阳分洪数。或阴分蹇涩。此乃偏胜之脉。惟寒惟热而已。不至于寒热争
第一条论述：胃气在人的脉象中本来应该是滑利而调和的。这原本是因为可能有邪气的侵袭，此时脉象在指下显得浑厚且位于中部。如果邪气停留日久，就会残害损伤这种胃气。当胃气被完全损伤殆尽时，生机也就断绝了。所以，人虽然生病了，但脉象中如果还有胃气存在，就可以治疗；如果没有胃气，就不能治疗。因此，诊脉的时候，既然出现了邪脉，仍然应当在表里之间仔细寻找胃气的踪迹。这种胃气之脉只会被邪脉所伤害，但最终不会与邪脉混杂在一起。所以应当审慎观察、分别查看，不可茫茫然没有分辨和区别。人如果能懂得这个医理，那么治病就成功了一半。
第二条论述：大肠的脉气从外部向下降行，三焦的脉气从内部向上升行，小肠的脉气从内部向下降行，膀胱的脉气从外部向上升行。所以《内经》说：“天阴之气自上而降，地阳之气自下而升”，就是这个意思。
详细论述：
第一条论述：前文记载六淫（风、寒、暑、湿、燥、火六种外感病邪）之气到来时，反映在指下的脉象必然有过盛或不足的形态。倘若六部脉象不实不坚，且散乱又聚集，而病症却表现在身体内部（中），这是无形之邪致病而有病的表现。殊不知人身有六气，有五运（五行之气的运行）。既然没有六气有余的邪气，那么就必定属于五运不足导致的邪气。这就是说邪气已经遏制，正气尚未恢复的意思。结合前面的论述来看。
第二条论述：什么是寒热交争呢？大概是因为阴气在外侵犯阳气，阳气与阴气相争（这里指的是寸口脉），或者阳气侵犯阴气，阴气与阳气相争（这里指的是尺部脉）。如果在表的阴邪，应当通过升发来恢复其阳的性质；如果在里的阳邪，应当通过降敛来恢复其阴的性质。阴阳各得其所，哪里还会有寒热的争竞呢？如果是阳分出现洪大数急的脉象，或者阴分出现蹇滞涩慢的脉象，这乃是偏胜的脉象，只是单纯的寒或热而已，不至于达到寒热交争的地步。
Article 1: The Stomach Qi (Wei Qi, stomach energy) in a person's pulse is inherently slippery and harmonious. Originally, this may be due to the arrival of pathogenic factors. In such cases, the pulse appears profound and central under the fingers. If pathogens remain for a long time, they will damage this Qi. When this Qi is completely exhausted, the vital life force ceases. Therefore, even if a person is ill, if there is still Stomach Qi in the pulse, it can be treated; if absent, it cannot be treated. Thus, during pulse diagnosis, although pathological pulses are present, one must still search within the exterior and interior for traces of Stomach Qi. This pulse of Stomach Qi can only be injured by pathological pulses but ultimately does not mix with them. Therefore, careful observation and distinction are required; one must not be confused without differentiation. If one understands this medical principle, success in treatment is more than halfway achieved.
Article 2: The pulse of the Large Intestine descends from the exterior, while the pulse of the Sanjiao (Triple Burner) ascends from the interior. The pulse of the Small Intestine descends from the interior, and the pulse of the Bladder ascends from the exterior. Hence, the *Neijing* (Classic of Internal Medicine) states: "Heavenly Yin descends from above, Earthly Yang ascends from below," which reflects this meaning.
Detailed Discussion:
Article 1: As recorded previously, when the Six Excesses (Liu Yin, six types of external pathogenic factors: wind, cold, summerheat, dampness, dryness, fire) arrive, the pulse felt under the fingers must show signs of excess or deficiency. If the six positions of the pulse are neither solid nor firm, appearing both scattered and gathered, yet the symptoms manifest internally, this indicates disease caused by formless pathogens. One should not fail to realize that the human body possesses Six Qi and Five Movements (Wu Yun, the movement of the five phases). Since there is no excess pathogen from the Six Qi, it must belong to the deficiency pathogen arising from the Five Movements. This refers to the state where pathogens have been suppressed but healthy Qi has not yet recovered. Consider this in conjunction with the previous discussion.
Article 2: What constitutes the contention between Cold and Heat? It is generally because Yin attacks Yang from the exterior, causing Yang to contend with Yin (this refers to the Cun position at the wrist), or Yang attacks Yin, causing Yin to contend with Yang (this refers to the Chi position at the wrist). If Yin pathogens are in the exterior, they should be dispersed and raised to restore their Yang nature; if Yang pathogens are in the interior, they should be descended and collected to restore their Yin nature. When Yin and Yang are in their proper places, what contention of Cold and Heat could there be? However, if the Yang position shows a洪 (Hong, surging) and 数 (Shuo, rapid) pulse, or the Yin position shows a 蹇 (Jian, slow/stagnant) and 涩 (Se, choppy) pulse, these are merely pulses of excessive dominance, representing either pure Cold or pure Heat, not reaching the level of contention between Cold and Heat.